Stroke: First Aid

A stroke occurs when there’s bleeding into your brain or when blood flow to your brain is blocked. Within minutes of being deprived of essential nutrients, brain cells start dying.

Seek immediate medical assistance. A stroke is a true emergency. The sooner treatment is given, the more likely it is that damage can be minimized. Every moment counts.

In the event of a possible stroke, use F.A.S.T. to help remember warning signs.

  • Face. Does the face droop on one side when the person tries to smile?
  • Arms. Is one arm lower when the person tries to raise both arms?
  • Speech. Can the person repeat a simple sentence? Is speech slurred or hard to understand?
  • Time. During a stroke every minute counts. If you observe any of these signs, call 911 or your local emergency number immediately.

Other signs and symptoms of a stroke, which come on suddenly, include:

  • Weakness or numbness on one side of the body, including either leg
  • Dimness, blurring, or loss of vision, particularly in one eye
  • Severe headache—a bolt out of the blue—with no apparent cause
  • Unexplained dizziness, unsteadiness, or a sudden fall, especially if accompanied by any of the other signs or symptoms

Risk factors for stroke include having high blood pressure, having had a previous stroke, smoking, having diabetes, and having heart disease. Your risk of stroke increases as you age.

Updated: 2017-09-30

Publication Date: 2017-09-30

Either too much or too little weight gain during pregnancy is associated with adverse outcomes in children aged 7 years

New research published in Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]) shows that if a woman gains either too much or too little weight during pregnancy, there are adverse effects in children at 7 years of age. The study is by Professor Wing Hung Tam and Professor Ronald C.W. Ma, at The Chinese University of Hong Kong, Shatin, Hong Kong, and colleagues.

There have been various studies on the effects of weight gain during pregnancy (gestational weight gain or GWG), however data on the metabolic effects in the children subsequently born have not been comprehensively studied. This study aims to evaluate the relationship between GWG and cardiometabolic risk in offspring aged 7 years.

The study included a total of 905 mother-child pairs who were enrolled in the follow-up visit of the multicentre Hyperglycemia and Adverse Pregnancy Outcome study, at the study centre in Hong Kong. Women were classified as having gained weight below, within or exceeding the 2009 Institute of Medicine (IOM) guidelines. Also factored in the study were standardised GWG values based on pre-pregnancy body-mass index (BMI).

Among the 905 women, the mean pre-pregnancy BMI was 21 kg/m2, the total prevalence of overweight and/or obese participants was 8.3%. The weight change from pre-pregnancy to delivery was 15kg on average, with 17% having gained weight below, 42% having gained weight within and 41% having gained weight exceeding the IOM recommendation.

Independent of pre-pregnancy BMI, gestational hyperglycaemia and other confounders, women who gained more weight than the IOM recommendation had offspring with larger body size at age 7 years, and increased odds of higher body fat, high blood pressure and poor blood sugar control, while women who gained less than the recommendation had offspring with increased risks of high blood pressure and poor blood sugar control at 7 years of age, compared with those who gained weight within the recommended range.

The authors say: “We found evidence of linkage between GWG and several cardiometabolic risk factors in the offspring aged 7 years, independently of maternal BMI prior to pregnancy and glucose level during pregnancy. These findings have important implications for both prevention and treatment. There is a need for greater awareness and monitoring of weight gain during pregnancy. Pregnancy might be a potential window of opportunity for intervention through modifiable behaviours, including maternal nutrition and physical activity.”

However, they add: “Although limiting excessive GWG may help minimise the intergenerational cycle of obesity, the benefits of lower weight gain must be balanced against other cardiometabolic risks — such as high blood pressure and poorer blood sugar control — and risk of stunted growth in the offspring if GWG is inadequate.”

They conclude: “Long-term follow-up of these children is necessary to evaluate the effect of maternal GWG on cardiometabolic risk in adolescence and adulthood.”

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Matthew Perry Just Spent 3 Months in the Hospital After a ‘Gastrointestinal Perforation’

Having a gastrointestinal perforation—a hole somewhere along your gastrointestinal tract—probably isn’t anyone’s idea of a good time. Unfortunately, Matthew Perry had to endure that and spend three months in the hospital, he revealed on Twitter recently.

“Matthew Perry recently underwent surgery in a Los Angeles hospital to repair a gastrointestinal perforation,” a publicist confirmed to People last month. “He is grateful for the concern and asks for continued privacy as he heals.”

And on Friday, Perry gave an update on Twitter: “Three months in a hospital bed. Check,” he wrote in his first tweet in six months.

Although we obviously don’t know the details of Perry’s situation, we do know that a gastrointestinal perforation can be a seriously painful condition.

A gastrointestinal perforation is a hole that develops along the gastrointestinal tract, meaning it could be on your esophagus, stomach, small intestine, large intestine, rectum, or gallbladder, MedlinePlus explains. These holes can develop after having illnesses (like appendicitis), having an underlying gastrointestinal condition (such as Crohn’s disease or ulcerative colitis), or after having abdominal surgery or procedures (such as a colonoscopy).

And that can be incredibly dangerous. “When there is a hole in the intestine, people can get very sick because the bacteria and food that usually stays in your intestinal tract gets to places where it shouldn’t be,” Heather Yeo, M.D., a colon and rectal surgeon at NewYork-Presbyterian and Weill Cornell Medicine, who was not involved in Perry’s treatment, tells SELF.

If the contents of your intestinal tract leak into your abdomen, it could cause severe complications, such as infections, such as peritonitis (an inflammation of the membrane that lines the abdominal wall) or sepsis (a potentially life-threatening response to infection).

Treatment for this usually involves emergency surgery.

If you have a gastrointestinal perforation, you might develop sudden and severe abdominal pain and tenderness, nausea, vomiting, and lack of appetite. “Someone will have a tense and rigid stomach with severe pain,” Anton Bilchik, M.D., Ph.D., professor of surgery and chief of gastrointestinal research at John Wayne Cancer Institute at Providence Saint John’s Health Center in Santa Monica, Calif., who was not involved in Perry’s treatment, tells SELF. “It’s usually not subtle.”

In some rare cases, you may not need surgery and can just be treated with antibiotics. But most of the time, emergency surgery is necessary to remove and repair a small part of the intestine, Dr. Bilchik says. And, if an abscess has formed, it may need to be drained.

The type of recovery you can expect depends on the cause of your perforation, the surgery you needed, and whether or not you developed an infection, Dr. Bilchik says.

For instance, if you got a perforation during a colonoscopy, your doctor spotted it quickly, and operated immediately, you’ll probably just be in the hospital for a few days, he says. But if it wasn’t spotted quickly, you didn’t seek care for a few days, and developed peritonitis or sepsis, you’re going to be hospitalized for much longer. “That’s the kind of person that may well be in the hospital for months,” Dr. Bilchik says.

Even after you have surgery, infection is a common complication and it can happen either inside your abdomen or throughout your whole body, the Mayo Clinic says. “A lot of it depends on how much bacteria or infection is in the abdomen,” Dr. Yeo adds. “Sometimes patients can have a prolonged stay.”

But that’s not always the case. “Most of the time, people are in the hospital for about a week,” Dr. Yeo says, but it may take a month or two to “feel back to themselves again.”


Thinking beyond yourself can make you more open to healthy lifestyle choices

Public health messages often tell people things they don’t want to hear: Smokers should stop smoking. Sedentary people need to get moving. Trade your pizza and hot dogs for a salad with lean protein.

For many people, these messages trigger our natural defenses. They make us feel bad about ourselves and our choices, leading our subconscious to reject the healthy encouragement.

However, a new study published in PNAS found that a simple priming exercise in which sedentary people think beyond themselves before viewing health messages can make those messages more effective. Not only did participants’ brain activity show that they were more receptive to the messages, but they actually became more physically active in the weeks that followed.

The study involved 220 sedentary adults who were either overweight or obese — people whose lack of physical activity puts them at increased risk for a variety of negative health outcomes.

“One of the things that gets in the way of people changing their behavior is defensiveness,” explains senior author Emily Falk, Associate Professor of Communication, Psychology, and Marketing at the University of Pennsylvania’s Annenberg School for Communication. “When people are reminded that it’s better to park the car further away and get in a few more steps, or to get up and move around at work to lower their risk for heart disease, they often come up with reasons why these suggestions might be relevant for somebody else, but not for them.”

To combat those defensive feelings, researchers engaged the participants in one of two self-transcendence tasks and compared their responses to those in a non-transcendent control group. Self-transcendence tasks required participants to think about values bigger than themselves — such as people they loved and cared about — and did so while the subjects were in an fMRI machine, allowing researchers to see their brain activity in real time.

The first self-transcendence group reflected on things that mattered most to them. If they chose “friends and family,” they might be asked to think about times in the future when they might feel close to their friends and family. If they chose “spirituality,” they might be asked to think about times when they might connect with God or other sources of higher power.

A second self-transcendence group was asked to make repeated positive wishes for both people they knew and for strangers. These included hopes that your friends would be joyful or that others would be well.

Meanwhile, a control group reflected on their least important values.

Then all the participants viewed blunt health messages that encouraged them to be more active, or explained why their current behaviors put them at risk. For example:

  • Getting more active will strengthen your muscles. Stronger muscles will make it easier for you to get around and do the things you enjoy for longer.
  • Make a habit of walking up and down the stairs whenever you can. Avoid taking the elevator as often as possible.
  • The American Heart Association says sedentary people like you are at serious risk for heart disease. This means more pills and higher risk of sickness and death.

In the month that followed, participants received daily text messages that repeated the experiment in miniature, priming them to think self-transcendent thoughts (or neutral control thoughts) before they received health messages. The also wore fitness trackers to monitor their activity.

Those who had completed either of the self-transcendence tasks were significantly more active in the month that followed, with less time spent being sedentary.

In addition, the researchers found that during the self-transcendence tasks, people showed greater activity in brain regions involved in reward and positive-valuation, when compared to the control group.

“People often report that self-transcendence is an intrinsically rewarding experience,” says lead author Yoona Kang, a postdoctoral fellow with the Annenberg School for Communication at the University of Pennsylvania. “When you are having concerns for others, these can be rewarding moments.”

These rewarding feelings, the researchers believe, can lead people to be more open to hearing otherwise-unwelcome health advice.

“If you let people first ‘zoom out’ and think about the things and people that matter most to them,” says Falk, “then they see that their self-concept and self-worth aren’t tied to this particular behavior — in this case, their lack of physical activity.”

Kang also points out that allowing people to feel part of something larger than themselves can have positive health effects.

“People are capable of doing things for their loved ones that they’d probably never do for themselves,” she says. “The idea of self-transcendence — caring for others beyond one’s own self-interest — is a potentially powerful source of change.”

The researchers are currently testing a phone app for the general public which delivers daily pairs of self-affirming and health messages, like those used in the study. Click here to download the app from the iTunes store.

“Effects of Self-Transcendence on Neural Responses to Persuasive Messages and Health Behavior Change” was published today in Proceedings of the National Academy of Sciences. Authors on the paper include Yoona Kang, Nicole Cooper (University of Pennsylvania), Prateekshit Pandey (University of Pennsylvania), Christin Scholz (University of Amsterdam), Matthew Brook O’Donnell (University of Pennsylvania), Matthew Liberman (University of California, Los Angeles), Shelley Taylor (University of California, Los Angeles), Victor Strecher (University of Michigan), Sonya Dal Cin (University of Michigan), Sara Konrath (Indiana University-Purdue University Indianapolis), Thad Polk (University of Michigan), Kenneth Resnicow (University of Michigan), Lawrence An (University of Michigan), and Emily Falk.

This research was supported by NIH/National Cancer Institute Grant 1R01CA180015-01 (P.I. Emily Falk) and NIH New Innovator Award 1DP2DA03515601 (P.I. Emily Falk), as well as funding from the John Templeton Foundation, U.S. Army Research Laboratory under cooperative agreement W911NF-10-2-0022, and HopeLab.

Stress over fussy eating prompts parents to pressure or reward at mealtime

Although fussy eating is developmentally normal and transient phase for most children, the behavior can be stressful for parents. A new study published in the Journal of Nutrition Education and Behavior found that concern over fussy eating prompts both mothers and fathers to use non-responsive feeding practices such as pressuring or rewarding for eating.

“These practices can reinforce fussy eating, increase preferences for unhealthy foods, and lead to excessive weight gain,” said lead author Holly Harris, PhD, Centre for Children’s Health Research, Queensland University of Technology, Brisbane, Australia. “Understanding why parents respond unproductively to fussy eating is an important step to educate on healthy feeding practices.”

This study recruited 208 mothers and fathers with children between the ages of 2-5 years from a socio-economically disadvantaged community in Queensland, Australia. Disadvantaged families are found to have higher levels of fussy eating and greater use of non-responsive feeding practices, but there is little understanding of what situations prompt this behavior.

In addition to information about themselves, the parents scored their perceived responsibility in feeding as well as their child’s temperament. Additionally, they reported the frequency of fussy eating behavior and their feeding practices. Questions included, “When your child refuses food they usually eat, do you insist your child eat it?” and “When your child refuses food they usually eat, do you encourage eating by offering a reward other than food?” Lastly, parents indicated how frequently they were worried about their child’s fussy eating, their child not eating a balanced or varied diet, and how much food their child ate.

The study found that while both mothers’ and fathers’ reports of fussy eating were consistent, mothers reported higher levels of concern. Research indicates gender assumptions place greater responsibility for feeding and the child’s nutrition on mothers. Mothers are also more sensitive to a child’s verbal and nonverbal cues. They are therefore more distressed by the crying, tantrums, and gagging as a child refuses food. Feeding has a significant emotional component for mothers that may contribute to their using nonresponsive feeding behaviors out of concern for the child’s welfare.

“Fathers more frequently used persuasive feeding practices, but their behavior was not driven by parental concern,” said Dr. Harris. “A possible explanation may be the fathers focus on practical matters such as ending mealtime after a long day at work. Acknowledging and addressing the underlying causes for non-responsive feeding practices used by both parents may improve responses to fussy eating.”

Dr. Harris suggests that health professionals tasked with advising parents of fussy eaters might consider providing reassurance, education, and alternative behavioral strategies to support children’s exposure to a wide variety of healthy foods.

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Shifting focus from life extension to ‘healthspan’ extension

Clinicians, scientists and public health professionals should proudly “declare victory” in their efforts to extend the human lifespan to its very limits, according to University of Illinois at Chicago epidemiologist S. Jay Olshansky.

In an article published in the Journal of the American Medical Association, Olshansky writes that the focus should shift to compressing the “red zone” — the time at the end of life characterized by frailty and disease, and extending the “healthspan” — the length of time when a person is alive and healthy.

Olshansky, professor of epidemiology in the UIC School of Public Health, discusses how human longevity has reached into its upper limits and has little room for further gains. He notes that at the turn of the 20th century, life expectancy at birth in most developed nations ranged from 45 to 50 years. With the emergence of major public health initiatives in the late 19th century — including sanitation and the public provision of clean water — mortality rates dropped, and life expectancy increased rapidly. The rise in longevity has slowed considerably in recent decades, and maximum lifespan has never changed much throughout human history.

Today, 96 percent of infants born in developed nations will live to age 50 and older, more than 84 percent will survive to age 65 or older, and 75 percent of all deaths will occur between the ages of 65 and 95 years old.

He also addresses the controversy that has erupted in the media lately over whether the human lifespan can increase indefinitely.

“There’s been a lot of focus in the news lately about what is the maximum human lifespan, with some researchers claiming that it has the potential to be infinite, but there is a biologically based limit imposed largely by the way in which our bodies are designed, and it can be expressed mathematically,” Olshansky said.

Based on the science and medicine available today, he contends that the probability of any significant increase in maximum lifespan in this century is remote.

“There is reason to be optimistic that future breakthroughs in aging biology, if pursued, could allow humanity to live healthier longer,” Olshansky said. “Some experts suggest that if death rates plateau at older ages, lifespans may continue to increase. This latter view has been challenged by the fact that an unrealistically high number of people would have to survive to age 105 (estimated 262,200) just for one person to exceed the world record for longevity by one year to 123 years.”

The downside of extremely long lifespans is that disease and disability tend to pile up toward the end of life.

“You don’t want to live to be over 100 years old if the last 20 years of your life are spent in pain and sickness,” Olshansky said. “Ideally, you want to compress the years of decay and disease — what I call the ‘red zone’ — into as few as possible at the very end of life. We should not continue to pursue life extension without considering the health consequences of living longer lives.”

Clinical trials that target aging have been approved by the Food and Drug Administration, and the American Federation for Aging Research is leading global efforts to secure funding for geroscience-related initiatives.

“This will be the only way science can push through the biological barriers to life extension that exist today,” he said. “Life extension should no longer be the primary goal of medicine when applied to people over age 65 — the principal outcome and most important metric of success should be extension of the healthspan.”

Olshansky cautions that despite longevity-related progress, many disparities are largely unresolved.

“Not everyone has access to health care, nutritious food, opportunities to get exercise and education that contribute to long lifespans,” he said.

Funding for elements of the Longevity Dividend concept was provided by the MacArthur Foundation, through its Research Network on an Aging Society, and a Glenn Award for Medical Research from the Glenn Foundation. Olshansky is co-founder and chief scientist at Lapetus Solutions, Inc.

Do rock climbers seek out high-risk climbs?

The sport of rock climbing is gaining international attention, having been approved for inclusion in the 2020 Olympic Games. But news headlines about the sport are still dominated by reports of gruesome injuries and near-death falls. Are rock climbers going out of their way to seek these risks? A new study published in Risk Analysis: An International Journal reveals that decreasing the level of injury risk at a climbing site generates substantial welfare gains for climbers.

Risk of injury or death is an intrinsic part of rock climbing, whether done for sport or recreation, but not all climbers are thrill-seeking adrenaline junkies. The study, “Valuing the benefits of rock climbing and the welfare gains from decreasing injury risk,” shows that these risks can heavily impact where individuals choose to climb.

The team of researchers, Lea Nicita and Giovanni Signorello, from the University of Catania, and W. Douglass Shaw, from Texas A&M University, applied the Kuhn-Tucker approach (conditions for an optimal solution in nonlinear programming) to estimate the demand for rock climbing in Sicily, Italy, to reveal the recreational value of various sites and the value to climbers of a reduction in injury risks. In addition to the degree of difficulty at the sites, climbers also consider length and quality of the climb, approach time, crowding and scenic quality, and travel costs, as well as variables that control for other unknown site-specific influences, when selecting a site to visit for climbing.

Thirty-two rock climbing sites located throughout Sicily were considered in the online survey distributed to Sicilian climbing groups on Facebook and via mailing lists from several climbing clubs. Ninety climbers completed the survey which asked questions about their place of residence, the number of trips taken to each of the 32 sites, self-reported climbing ability, experience, preference for sport or traditional climbing, whether they’ve attended training courses, are members of a club, whether they climb alone and their socioeconomic status. The average climbing ability of the respondents can be described today as handling routes of “moderate” difficulty, the equivalent of a U.S. 5.10 grade.

The researchers used knowledge of the climbing bolts and rope run-outs at each site to determine if a route was low, moderate or high risk. The distance between any pair of fixed bolts determines the level of protection and risk as the climber can fall more than twice the distance he or she is above the last bolt. For example, a run-out of 10 feet between bolts may result in a 25-foot fall. While previous studies have explored bolting for sport climbing, they focus more on the environmental consequences of bolting, than the safety afforded to climbers.

The results revealed that a greater quantity of single-pitch routes, higher quality landscape and a lower level of median difficulty all increase the likelihood of climbers visiting the site. A statistical analysis of the responses indicated that the climbers preferred lower risk routes.

The researchers also estimated welfare values for each site to help inform policy maker who might set regulations regarding access to the site and to assess the recreational gains of investing in climbing routes to reduce the level of injury risk. Risk reductions at nearly every site can be achieved by improving the bolting of existing routes. If a policy were introduced to increase the level of protection for climbers, the resulting reduction of injury risk is predicted to generate a welfare gain ranging from $18 to $327, depending on the individual site. “The study has broader implications for assessing other risky activities (e.g., undertaking risky sports and forms of transportation such as biking, risky diets and behaviors) and the value of risk reductions for those,” stated Nicita.

The researchers concluded that rock climbing sites with more routes and a better scenic view are more likely to be visited. Most notably, they found that climbers are more likely to choose less risky sites. While risk of injury from falling is intrinsic to the nature of the sport, there is a widespread misperception about the sport in part due to the media coverage and National Geographic filming of climber Alex Honnold, who free-soloed Yosemite Valley’s El Capitan. The values for injury risk reductions revealed by this study can be compared to the cost of increasing safety at a site which can be done by replacing old, worn out bolts and decreasing the length of run-outs.

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10 of the Best Fall Hiking Tours in the U.S., According to TripAdvisor

Let me tell you why fall hikes are the best. You get all the sunshine of summer without the heat, so you can wear your best leggings without worrying about sweating your face off. And if you’re into leaf peeping, fall is the time to check out the bright, glowing colors of those changing leaves. It’s glorious.

To help you decide where to hike this fall, we checked in with TripAdvisor to find out which hikes reviewers loved most. The data team at TripAdvisor used the traveler rankings—an algorithm that ranks experiences based on the quality, quantity, and recency of reviews on the site—to find the most popular hikes across across the U.S. during the months of September, October, and November. Then we did a little tweaking: Because TripAdvisor clumps camping and hiking tours into one category, we selected just the hikes, then took out some repeat locations (there were tons of popular hikes in Hawaii, for example, so we picked our favorites). All of the hikes below are guided tours—which offer expert help and advice, plus a local’s wisdom—but you can also ditch the guide and go on most of these hikes on your own. (Except for number seven, which is only accessible with a guide!)

Your mission: Try to hit up at least one of these this season, and if you can’t make it, add it to your hiking bucket list for 2019. Happy trailing!

Cancer Treatment Myths: Any Truth to These Common Beliefs?

As advances in the treatment of cancer have increased, you may have discovered more opportunities to learn the facts about this disease. Yet some misleading ideas about cancer treatment still persist.

Timothy J. Moynihan, M.D., a cancer specialist at Mayo Clinic, Rochester, Minnesota, helps debunk some of the most common misconceptions about cancer treatment and explains the truth.

Myth: A positive attitude is all you need to beat cancer.

Truth: There’s no scientific proof that a positive attitude gives you an advantage in cancer treatment or improves your chance of being cured.

What a positive attitude can do is improve the quality of your life during cancer treatment and beyond. You may be more likely to stay active, maintain ties to family and friends, and continue social activities. In turn, this may enhance your feeling of well-being and help you find the strength to deal with your cancer.

Myth: If we can put a man on the moon, we should have cured cancer by now.

Truth: Finding the cure for cancer is proving to be more complex than mastering the engineering and physics required for spaceflight.

Cancer actually includes a large group of diseases. Each can have many different causes. Despite advances in diagnosis and treatment, doctors still have much to learn about what triggers a cell to become cancerous and why some people with cancer do better than others.

In addition, cancer is a moving target. Cancer cells may continue to mutate and change during the course of the disease. This may lead to the cancer cells no longer responding to the chemotherapy drugs or radiation treatments that were given initially.

Myth: Drug companies and the Food and Drug Administration (FDA) are blocking or withholding new cancer treatments.

Truth: Your doctor and the FDA, which must approve new drugs before they can be marketed, are your allies. As such, they make your safety a high priority.

Unfortunately, scientific studies to determine the safety and effectiveness of new cancer treatments take time. That may create the appearance or lead to reports that effective new treatments are being blocked.

If you still believe a cure is being purposefully withheld, ask yourself why a doctor would choose to specialize in cancer research. Doctors often go into cancer research because they have a family member or friend affected by the disease.

Doctors are as interested in finding a cure as anyone else, for the same reason—it affects them personally. They hate to see a loved one in pain and don’t wish to lose this person. They also want to spare others what they have gone through.

Myth: Regular checkups and today’s medical technology can detect all cancer early.

Truth: Although regular medical care can indeed increase the ability to detect cancer early, it can’t guarantee it. Cancer is a complicated disease, and there’s no sure way to always spot it.

Routine screening has been linked to a decrease in deaths from cancers of the cervix, breast, lung, colon, and rectum.

Myth: Undergoing cancer treatment means you can’t live at home, work or go about your usual activities.

Truth: Most people with cancer are treated on an outpatient basis in their home communities.

At times it may be helpful to travel to a specialty medical center for treatment. But often, doctors at such a medical center can work with doctors in your hometown so that you can be with your family and friends and perhaps even resume work.

A lot of research has gone into making it easier for people to live more normal lives during their cancer treatment. For example, drugs are now available to help better control nausea. The result is you’re often able to work and stay active during your treatment.

Myth: Cancer is always painful.

Truth: Some cancers never cause pain.

For people who do experience cancer pain, especially people with advanced cancer, doctors have become more aware of the need to control such pain and have learned better ways to manage it. Although all pain may not be eliminated, it may be controlled so that it has little impact on your daily routine.

Myth: A needle biopsy can disturb cancer cells, causing them to travel to other parts of the body.

Truth: For most types of cancer, there’s no conclusive evidence that a needle biopsy—a procedure used to diagnose many types of cancer—causes cancer cells to spread.

There are exceptions, though, of which doctors and surgeons are aware. For instance, a needle biopsy usually isn’t used in diagnosing testicular cancer. Instead, if a doctor suspects testicular cancer, the testicle is removed.

Myth: Surgery causes cancer to spread.

Truth: Surgery can’t cause cancer to spread. Don’t delay or refuse treatment because of this myth. Surgically removing cancer is often the first and most important treatment.

Some people may believe this myth because they feel worse during recovery than they did before surgery. And if your surgeon discovers during surgery that your cancer is more advanced than first thought, you may believe the surgery caused more extensive cancer. But there is no evidence to support this.

Myth: Everyone with the same kind of cancer gets the same kind of treatment.

Truth: Your doctor tailors your treatment to you. What treatment you receive depends on where your cancer is, whether or how much it has spread, and how it’s affecting your body functions and your general health.

More and more, cancer treatment is being tailored based on your genes. These genes, which you’re born with, may show that your body processes certain chemotherapy treatments and drugs differently than someone else’s body. Genetic testing on your cancer cells can also help guide your treatment.

Myth: Everyone who has cancer has to have treatment.

Truth: It’s up to you whether you want to treat your cancer. You can decide this after consulting with your doctor and learning about your options.

A person with cancer might choose to forgo treatment if he or she has:

  • A slow-growing cancer. Some people with cancer might not have any signs or symptoms. Lab tests might reveal that the cancer is growing very slowly. These people might choose to wait and watch the cancer. If it suddenly begins growing more quickly, treatment is always an option.
  • Other medical conditions. If you have other significant illnesses, you may choose not to treat your cancer, as the cancer may not be the biggest threat to your health. This may be especially true in the case of a slow-growing cancer.
  • A late-stage cancer. If the burden of treatment side effects outweighs the benefit that treatment can bring, you might choose not to be treated. But that doesn’t mean your doctor will abandon you. Your doctor can still provide comfort measures, such as pain relief.

Updated: 2017-03-31

Publication Date: 2000-05-04

Sperm quality study updates advice for couples trying to conceive

Could doctors at fertility clinics be giving men bad advice? Dr. Da Li and Dr. XiuXia Wang, who are clinician-researchers at the Center for Reproductive Medicine of Shengjing Hospital in Shenyang in northeast China, think so.

Recent research from Li’s and Wang’s lab, published in the journal Molecular and Cellular Proteomics, upends conventional wisdom that abstaining between efforts to conceive can improve a couple’s chances of success. The research team worked with almost 500 couples to test whether how long a couple waits between efforts to conceive could change their success rates.

“For years, men have usually been advised to limit sexual activity to increase the chances of pregnancy,” said Li. “However, it’s time to change our minds.”

Some earlier studies had shown that semen produced shortly after a man’s most recent ejaculation — within three hours or so — had faster and more motile sperm than if the man abstained for several days before ejaculating again. But it wasn’t clear why the sperm changed or whether the changes affected fertility. So researchers set up a few side-by-side experiments to investigate.

They looked at individual subjects’ semen after they had abstained for either several days or just an hour or two, comparing the volume of semen and the mobility of sperm. As had been observed earlier, the sperm from shorter abstinence periods moved faster.

Using a technique called mass spectrometry to look at the protein makeup of the samples, the team found some major molecular differences. The majority of the affected proteins were involved in cell adhesion, a function that sperm need in order to fuse with egg cells.

The team also observed changes to proteins involved in sperm motility and metabolism, especially in proteins that handle reactive oxygen species, a byproduct of cellular energy production. Although reactive oxygen species are needed for some normal sperm functions, having an excess can damage sperm’s genetic material.

According to Li’s results, the longer sperm exist, the more vulnerable they are to DNA damage by reactive oxygen, which could harm their ability to form a viable embryo.

To see whether the changes to sperm were affecting fertility, research team also ran a study of about 500 couples preparing for in vitro fertilization at the fertility clinic. They asked men in the control group for semen samples after several days of abstinence, whereas men in the experimental group abstained for less than three hours before providing their samples. The IVF team proceeded as usual with the two types of sample, using them to generate and then implant embryos.

“A typical live birth rate in a cohort of this size is about 30 percent,” said Li. In the experimental cohort, live births were higher by one-third.

“Our data indicate that couples with relatively normal semen parameters should have frequent sex around the ovulation period,” said Li. “This could make all the difference to their efforts to start a family.” Meanwhile, IVF treatments at the Center for Reproductive Medicine, which treats about 5000 infertile couples per year, are also being updated to use semen from closer-spaced ejaculations.

Li said that the team plans to continue working with patients and will perform further research to investigate differences in post-translational modifications that his lab saw between the types of samples. “This is a very new field,” said Li. But the prospects for would-be parents are exciting.